An Innovative Method of Assessing the Mechanical Axis Deviation in the Lower Limb in Standing Position

Kamath, Jagannath B; Danda, Raja Shekar; Jayasheelan, Nikil; Singh, Rohit

doi:10.7860/jcdr/2016/17324.8042

Cited by 8 publications

(6 citation statements)

References 13 publications

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“…Hence the medial compartment of the knee is overloaded by 50% compared to the lateral compartment. 18 MAD is the distance between the mechanical axis line and the center of the knee in the frontal plane. A lateralized MAD, reflected by an increase of the distance between the mechanical axis and knee joint center, leads to a shift of the mechanical load to the lateral knee compartment.…”

Section: Discussionmentioning

confidence: 99%

Mechanical Lateral Distal Femoral Angle (MLDFA), Medial Proximal Tibia Angle (MPTA), and Mechanical Axis Deviation (MAD) Value in Young Adults in North Sumatera

Winanto

Ismiarto²

2022

CDK

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Introduction. Reference value to determine the angle of lower extremity is only based on clinical measurement and radiological assessment, which is limited to tibiofemoral angle (TFA). Although this examination can estimate the lower extremity angle, it is not satisfactory for a comprehensive analysis. Material and Method. A descriptive study in RSUP Haji Adam Malik Hospital in August - September 2019 to measure mechanical lateral distal femoral angle (MLDFA), medial proximal tibia angle (MPTA), and mechanical axis deviation (MAD). Results. Thirty nine subjects were included in this study. The mean age was 26.77±4,65 years old (range: 22 to 39 years); 69,2% were male (n = 27) and 30,8% were female (n = 12). The average mechanical lateral distal femoral angle (MLDFA) was 87,93o ±2,16o . The average medial proximal tibia angle (MPTA) was 86,28o ±2,26o . The average mechanical axis deviation (MAD) was 1.56±1,48 mm. Our results of MLDFA and MPTA measurement, but not in MAD, are consistent with study conducted by Farr, et al. Conclusion. Our MLDFA, MPTA, but not MAD measurement results are similar to studies involving Caucasian population.Pendahuluan. Nilai acuan sudut pada ekstremitas bawah hanya berdasarkan pemeriksaan klinis dan radiologis, yang terbatas pada sudut tibiofemoral. Pemeriksaan sudut tibiofemoral (STF) tunggal tidak cukup untuk analisis komprehensif ekstremitas bawah. Bahan dan Cara. Penelitian deskriptif di RSUP Haji Adam Malik pada bulan Agustus – September 2019 untuk mengukur sudut mekanik lateral distal femur (SMLDF), sudut medial proksimal tibia (SMPT), dan deviasi aksis mekanik (DAM). Hasil. Sejumlah 39 subjek diteliti. Usia rata-rata 26,77 ± 4,65 tahun (22 - 39 tahun); 69,2% pria (n = 27) dan 30,8% wanita (n = 12). Nilai rata-rata sudut mekanik lateral distal femur (SMLDF) adalah 87,93º ± 2,16º. Nilai rata-rata sudut medial proksimal tibia (SMPT) adalah 86,28º ± 2,26º. Nilai rata–rata deviasi aksis mekanik (DAM) adalah 1.56 ± 1,48 mm. Pada penelitian ini, hasil pengukuran SMLDF dan SMPT sesuai hasil penelitian Farr, et al, tetapi hasil pengukuran DAM tidak sesuai. Simpulan. Nilai SMLDF dan SMPT pada penelitian ini tidak berbeda dengan penelitian pada populasi Kaukasia

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Section: Discussionmentioning

confidence: 99%

Mechanical Lateral Distal Femoral Angle (MLDFA), Medial Proximal Tibia Angle (MPTA), and Mechanical Axis Deviation (MAD) Value in Young Adults in North Sumatera

Winanto

Ismiarto²

2022

CDK

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“…The process was conducted separately by two authors, whose values for the MAD of each patient were averaged. The distance between the centre of the knee and the mechanical axis defines the MAD and is proposed to be normal with 10 mm of medial deviation (range 3−17 mm) (23). The mechanical tibiofemoral angle was determined likewise by 1 author; here, normal values of 1.0° to 1.3° varus have been reported (27,28).…”

Section: Limb Alignment Analysismentioning

confidence: 99%

“…The mechanical axis (MA) is defined as the line joining the hip joint centre and the centre of the dome of the talus; the mechanical axis deviation (MAD) represents the distance of the MA from the knee joint centre in the frontal plane, as shown in Fig. 1 (23).…”

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confidence: 99%

Varus Knee Limits Pain Relief Effects of Laterally Wedged Insoles and Ankle-Foot Orthoses in Medial Knee Osteoarthritis

Bartsch

Schwarze

Block

et al. 2022

JRM

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Objective: To investigate the impact of varus malalignment of the knee on pain reduction achieved by an ankle-foot orthosis and a laterally wedged insole in patients with medial knee osteoarthritis.Design: Secondary analysis of a randomized, clinically prospective cross-over study.Patients: Twenty-eight participants with medial knee osteoarthritis.Methods: All participants wore a 5-mm laterally wedged insole and an ankle-foot orthosis for a period of 6 weeks each in a randomized order. Pain was reported on a numerical rating scale and was correlated with limb alignment, as defined by the mechanical axis deviation in full-leg standing radiographs.Results: Insole and orthosis use reduced pain compared with baseline (median knee pain change: insole –0.5 (? –5 to +6), orthosis –1.5 (–7 to +5). A higher mechanical axis deviation (greater varus) correlated significantly with smaller pain reduction for both aids (insole p = 0.003, orthosis p < 0.001). A cut-off to predict pain response was found at a mechanical axis deviation of 14–15 mm for both aids, i.e. > 3° knee varus.Conclusion: There is a correlation between varus malalignment and pain reduction. There seems to be a mechanical axis deviation cut-off that predicts the response to treatment with the aids with good sensitivity.

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“…The alignment of the lower extremity is frequently evaluated by extrapolating the femoral-tibial angle (FTA) and the mechanical axis from standing, full-length, plain radiographs [4,5]. However, the FTA and mechanical axis provide an incomplete picture of the alignment of the lower limb as they exclude assessment of the hindfoot axis.…”

Section: Introductionmentioning

confidence: 99%

Alignment of the Hindfoot Following Total Knee Arthroplasty: A Systematic Review

Azam¹,

Butler²,

Mercer³

et al. 2022

Foot & Ankle Orthopaedics

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BACKGROUNDThere appears to be a close relationship between deformities at the knee joint and at the hindfoot in patients with knee osteoarthritis (OA). Despite this intrinsic link, there is a dearth of studies investigating alterations in hindfoot alignment following total knee arthroplasty (TKA) in patients with knee OA. AIMTo evaluate changes in alignment of the hindfoot following TKA, foot and ankle clinical outcomes in terms of subjective clinical scoring tools following surgical intervention, and to analyse the level of evidence (LOE) and quality of evidence (QOE) of the included studies. METHODS MEDLINE, EMBASE and CochraneLibrary databases were systematically reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting changes in the postoperative alignment of the hindfoot following TKA were included. The level and QOE were recorded and assessed. RESULTSEleven studies with a total of 1142 patients (1358 knees) met the inclusion/ exclusion criteria. Six studies were of LOE II and 5 studies were of LOE III. Patients with preoperative varus knee deformity and valgus hindfoot deformity demonstrated improvement in hindfoot alignment post TKA. Patients with preoperative varus knee deformity and varus hindfoot deformity demonstrated no improvement in hindfoot alignment following TKA. Twelve different radiographic parameters were used to measure the alignment of the hindfoot across the included studies, with the tibio-calcaneal angle most frequently utilised Butler JJ et al. Hindfoot alignment following TKA WJO https://www.wjgnet.com

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An Innovative Method of Assessing the Mechanical Axis Deviation in the Lower Limb in Standing Position

Cited by 8 publications

References 13 publications

Mechanical Lateral Distal Femoral Angle (MLDFA), Medial Proximal Tibia Angle (MPTA), and Mechanical Axis Deviation (MAD) Value in Young Adults in North Sumatera

Mechanical Lateral Distal Femoral Angle (MLDFA), Medial Proximal Tibia Angle (MPTA), and Mechanical Axis Deviation (MAD) Value in Young Adults in North Sumatera

Varus Knee Limits Pain Relief Effects of Laterally Wedged Insoles and Ankle-Foot Orthoses in Medial Knee Osteoarthritis

Alignment of the Hindfoot Following Total Knee Arthroplasty: A Systematic Review

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